Teamcare Retiree Insurance Doesn't Pay If Spouse is Disabled
- Thread starter scratch
- Start date
Ha, I should set up a GoFundMe on The Teamster's Facebook page. We have already paid off several doctor bills, I'm thinking we may actually pay back $30K at the most making cash settlements. It just pisses me off that we paid premiums and Teamcare authorized every single doctor's appointment. Teamcare discriminates against disabled people and the IBT doesn't care.
trickpony1
Well-Known Member
Have you thought about getting a good attorney and going after Teamcare and the IBT?
I'm not an attorney but "breach of contract" and, as you say, discrimination come to mind.
Your issue could take years to resolve.
Good luck.
I'm not an attorney but "breach of contract" and, as you say, discrimination come to mind.
Your issue could take years to resolve.
Good luck.
My heart goes out to you my friend
Always helping...
We called about a dozen lawyers and none of them wanted to touch this. Obamacare has all kind of loopholes for national union healthcare plans. The state insurance commissioner's office told us the same thing. Teamcare took their payments back from the healthcare providers using the Blue Cross Blue Shield payment network. We haven't heard from over half of the 33 different doctor, hospital, and labs involved in this, we are hoping they are filing their own appeals. We know of one anesthesia practice that appealed on their own and they got their money back already. One of the things that really ticks me off is that Teamcare deleted all of my wife's statements from the Teamcare website and then they mailed us all the bills listing the full doctor's fees. So for most of these bills i don't know the exact discount they paid out the first time. Most of the doctor's billing people we have talked to are willing to settle for a "Cash Out" discount. I'm not worried about it as much as it has stressed my wife out. We are having an estate sale tomorrow to clean out her parents house so we can finally put it on market.
We are not on Teamcare, and my locals insurance is through Humana. My wife had a procedure done, which when we called called we were told we didn't need a pre-approval. My wife then did the chat with Humana and was also told we didn't need preapproval. After the surgery was complete we get a bill a couple months later for 10k for the operating room and 30K for the surgery.
Apparently, my wife's surgery is covered by Humana in every other instance except the Teamster plan I'm in. We would do the chat for clarification, and the Humana rep would tell us its covered. Great!, then fix this. They always seemed helpful, and tried to move the coverage up the chain. We did this a half dozen times.
Long story shorter... I filed a complaint with the BBB which went no where. I filed a complaint with the state insurance board. We had copies of all the chats which we forwarded to the insurance board. End result was the 10K room was comped. Humana did admit we tried to get preapproval multiple times, and they were incorrect telling us we didn't need it. We got interest on the money we never paid, and our total bill was less than $600.
It took 9 months with way too many emails, phone calls, and many times telling my wife not to agree to anything and don't set up a payment plan. It worked out, but shouldn't have been that hard.
Apparently, my wife's surgery is covered by Humana in every other instance except the Teamster plan I'm in. We would do the chat for clarification, and the Humana rep would tell us its covered. Great!, then fix this. They always seemed helpful, and tried to move the coverage up the chain. We did this a half dozen times.
Long story shorter... I filed a complaint with the BBB which went no where. I filed a complaint with the state insurance board. We had copies of all the chats which we forwarded to the insurance board. End result was the 10K room was comped. Humana did admit we tried to get preapproval multiple times, and they were incorrect telling us we didn't need it. We got interest on the money we never paid, and our total bill was less than $600.
It took 9 months with way too many emails, phone calls, and many times telling my wife not to agree to anything and don't set up a payment plan. It worked out, but shouldn't have been that hard.
DELACROIX
In the Spirit of Honore' Daumier
First: I wish ya'll the best.
Since my wife is an ongoing cancer patient and I recently retired.....
I read your plight and it makes me queasy.
Could you please.......again in simple terms for us dense folks.....short version of what happened?
You have insurance...right? Or Medicare...right? One or the other should've or could pay.......yes?
If one(side) wants all their money back.....then couldn't you file again?
And why exactly are you going to have to pay for it yourself....with insurance or medicare?
And if we had Union/UPS insurance/Medicare......we don't have coverage?
If someone misinformed you.......
My wife has an appointment tomorrow......I'm beginning to wonder.....
Sincerely thanks.
bleedinbrown58
That’s Craptacular
Why don’t you start a gofundme page? I would donate if you did. I’m sure some others on here would also.
We are still fighting this out with our second and final appeal, which is on Teamcare's Appeal docket in three or four weeks. If we lose I intend to pay it. I have investments I'm trying to stay out of so the sale of my in-laws house in a month or two should be more than enough to cover it. I just made this thread to warn other people so it doesn't happen to them. I honestly didn't realize that at my retirement time that Teamcare and Teamcare Retiree insurance are two different plans. As a driver, we were told that supposedly you and your spouse can pay $200 a month after retirement and stay on Teamcare until age 65 if in Central States. Teamcare had no problem covering my wife while I was working. I'm officially off Teamcare as of May 1 because I turn 65 this Saturday. My Aetna Advantage Plus Medicare Supplemental is a better and cheaper plan than Teamcare, its the same one my wife is now on. Teamcare had the nerve to send me an application for their "TeamStar" Medicare Supplemental, they can kiss my ass.
Thanks for the GoFundMe comment, I'm doing well financially.
Thebrownblob
Well-Known Member
Screw that, I want it!Well if you sell your golf cart with the kegerator on the back I want first bid on it
Well if you sell your golf cart with the kegerator on the back I want first bid on it
If your wife hasn't been declared disabled from her cancer and isn't able to receive Social Security benefits then I think you are okay for now. I strongly suggest you call your healthcare insurance person at your Local or Teamcare and ask about your situation to be sure.
In my case, we got married in 1983 and she went on Teamcare in 1984 when I bid into full-time package driving. In 1999, she got diagnosed with a genetic eye disease called Retinitus Pigmentosa and was told she would go completely blind in a few years. It took us two years of fighting to get her eligible for Social Security Disability Benefits, SSDI. At that time, she was told she could go on Medicare, but that only covered hospitalization without paying extra for a supplement. Disabled people are automatically able to go on Medicare at any age. She called Teamcare and explained her situation, and was told she had the option of Medicare or staying on Teamcare, you can't use both. Teamcare was a better option at the time, so she stayed on it. So I retired in October 2020, and $200 apiece started coming out of my UPS/IBT pension check as expected. I honestly did not know that Teamcare and Teamcare Retiree Insurance is two different plans, my Shop Steward and Business Agent didn't know either. So for two years, I paid for her Teamcare Retiree insurance and every one of her doctor's visits were pre-approved by them. She had three out-patient surgeries that pushed those costs high, and I suspect that Teamcare was looking for a way to drop her. So one day in October 2022, she gets a call from her eye doctor and is told she no longer has health insurance and they cancelled her appointment for the next day. Teamcare did not call me or send an email, we got a letter a week later telling us her insurance was cancelled and we would be asked to re-imburse her doctors for two years of medical care. At that time, the bills added up to $44,000 but they kept digging up every single thing they could find and that total got to about $94,000. We aren't going to pay back that much, most doctors will settle for a "cash out" to close out that account.
Thebrownblob
Well-Known Member
I was unaware it was different
I wasn't either, Teamcare sent me the very same card with the same policy number after I retired. It also doesn't say Teamcare Retiree Insurance on it.
Johney
Well-Known Member
It's very different. I pay more for medication's than when I was working.
Johney
Well-Known Member
Yup same card same number.
DELACROIX
In the Spirit of Honore' Daumier
@scratch ..A couple of things about your situation, I know laws change but when your wife found out about her diagnosis and called Team Care did they actually say that she could not have your active insurance and Medicare at the same time. My wife was had major medical issues at age 62 and had to get on to Medicare A and B six years prior to my retirement. She had both Team Care was her primary and Medicare A and B was her secondary. It did create a lot of head aches because of billing problems, when one healthcare provider would bill the wrong coverage, even after being provided all our medical information and changes.
When you go through a Major Medical Emergency and trying to keep up with your incoming Medical Bills is a pain in the ass, especially if you are not a numbers guy. I read through the SPD's that they send us and I still can't figure them out, the only way I found out that there are two separate Team Care coverages one for actives and one for retirees is on this site. Watch out for the annual limits is another factor when you retire, I do not know whether the Team Care Coverages are the same nationwide. I other words if you were under the Western's retiree's Health and Welfare package would that of made a difference?
It looks like there is a lot of auditing going on with Pensions and Health and Welfare coverages now, I do not if it has to do with our current Contract talks or not. The timing is interesting... From what you told us Team Care is only going back to your retirement back in 2020, You wonder why they did not catch their error prior to your retirement. You and your wife were doing it properly and paying that 400 dollar co-pay, your wife was apparently under Medicare A before your retirement and should of been put under Medicare B when she first started her disability. It will be hard to prove what has been been said in the past without documentation, sounds like Team Care and possibly Medicare never followed up or warned you of the loopholes connected with your wife's medical condition.
These billing processes between every Health Care provider and Insurer is simply ridiculous..again the Medical field bills for thousands of dollars and eventually settles to the agreed amount established by the Health Care providers which is considerably less. The whole system needs to be fixed, it appears that both sides are running amok now and playing the system. Guess who is caught in the middle?
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